Burhan Pişkin

Laparoscopic abdominal observation method without anesthesia for preventing unnecessary second-look procedures: short report.

Second-look operations after massive intestinal resections secondary to mesenterovascular occlusion are a frequent practice. In about one half of patients who undergo second-look procedures, no intraabdominal intervention is necessary. We present a laparoscopic abdominal observation method to prevent unnecessary laparotomies. In the first operation, two laparoscopic trocars, 5 and 10 mm in diameter, were left in the abdominal wall. After an appropriate time interval, the abdomen was explored laparoscopically through these trocars without anesthesia. If obvious intestinal gangrene and anastomotic leaks were observed laparoscopically, the patients were reoperated on while under general anesthesia; otherwise, the procedure was terminated with removal of the trocars. This method was performed on six patients. Unnecessary relaparotomies were prevented in four patients; intestinal gangrene and anastomotic leaks were not missed in the remaining two patients. A larger patient sample is needed to assess the advantages of this method in preventing unnecessary laparotomies.

A method for the closing up of abdominal trocar wound

SummaryLaparosocpic surgical techniques are widely used with many advantages. However, herniation through trocar wounds is observed as a complication. We present a new instrument and a new method for the secure closure of fascial defects of trocar wounds.

Kolorektal cerrahide ASEPSIS yöntemiyle yara takibi

GIRIŞ Kolorektal cerrahi geciren hastalar Yara yeri enfeksiyonlari (YYE) acisindan yuksek riske sahiptir (1,2). Yara yeri komplikasyonlarinin yakindan izlemi yara iyilesmesi ve hasta sag kalimi uzerinde olumlu etki yapmaktadir (3-8). Bu calismadaki amaclar kolorektal cerrahide YYE gelismesine neden olan faktorleri arastirmak, YYE siddetini ve iyilesme surecini yara skorlama yontemi olan ASEPSIS ile izlemek ve YYE riskini belirlemek amaciyla kullanilan NNIS (National Nosocomial Infections Surveillance System) ve SENIC (The Study on the Efficacy of Nosocomial Infection Control) yontemlerini karsilastirmaktir (4-12).

Do previous acid reducing procedures protect patients from short bowel syndrome?—A case report

SummaryBackgroundThe resection of large segments of small intestine can cause short bowel syndrome.MethodsA patient is described who underwent extensive bowel resection 15 years after vagotomy and antrectomy for peptic ulcer disease.Results p The patient did not develop short bowel syndrome.ConclusionsAcid reducing operations might have their place amongst other surgical procedures which have been proposed for treating refractory short bowel syndrome.ZusammenfassungGrundlagenNach Resektion großer Teile des Dünndarms entwickelt sich das Kurzdarmsyndrom.Methodik p Ein Patient mit ausgedehnter Dünndarmresektion 25 Jahre nach Vagotomie und Antrektomie wegen Ulcus pepticum, wird beschrieben.ErgebnisseDer Patient entwickelte kein Kurzdarmsyndrom.Schlu\folgerungenSäurereduzierende Operationen haben neben anderen chirurgischen Maßnahmen ihren Stellenwert zur wirkungsvollen Beeinflussung des Kurzdarmsyndroms.

Gangrenous acalculous cholecystitis in a newborn

A 12-day-old infant with acute gangrenous acalculous cholecystitis is described and the literature on this subject is reviewed.

A modified technique for performing anterior gastropexy in stamm gastrostomies

We describe herein a new modified technique for performing the anterior gastropexy step of the Stamm gastrostomy procedure. In this method, anterior gastropexy was carried out with four 2-0 silk or propylene sutures. These sutures were secured through the whole layer of the abdominal wall from out to within. Then, after passing the seromuscular layer of stomach, they return to skin through the abdominal wall from within to out and tied over the skin surface. This modified technique which provided better exposure and an excellent seal of the stomach and parietal peritoneum, was successfully performed on 23 patients, none of whom developed any peritoneal leakage and peritonitis. The only complications that arose were wound infection in one case and skin excoriation in two others, and these were easily managed.

Familial juvenile polyposis coli with congenital heart disease

Seven cases of familial juvenile polyposis coli (FSPC) and one case of familial adenomatous polyposis coli (FAPC) were described in two generations of a family. Of five siblings, one had FJPC with mitral insufficiency, one had Fallots tetralogy, and the other three, also with FJPC, had had pulmonic stenosis and died. Congenital heart disease was observed in neither the father nor the aunt. The grandfather also had FAPC, without congenital heart disease. To the best of our knowledge, this association has not previously been reported in the literature. For this paper members of the family were studied and the literature was reviewed.

Catheter related sepsis

In 100 patients plastic catheters were placed into the basilic vein for parenteral nutrition (n=40) and central venous pressure monitoring (n=60). Catheter related sepsis rates were compared between indication for parenteral nutrition (10%) and central venous pressure measurement (18%). Intraoperative complications were not seen.ZusammenfassungFür parenterale Ernährung wurden an 40 Patienten und für zentralvenöse Druckmessung an 60 weiteren Venenkatheter in die V. basilica gelegt. Katheterbedingte Sepsis trat bei der parenteral ernährten Gruppe in 10%, bei Patienten, bei denen zentralvenöse Druckmessung durchgeführt wurde, in 18% auf. Intraoperative Komplikationen wurden nicht beobachtet.